Provider Demographics
NPI:1932566031
Name:CASTRONOVO, LAUREN M (APN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:CASTRONOVO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 TREENA ST STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1140
Mailing Address - Country:US
Mailing Address - Phone:858-218-6544
Mailing Address - Fax:
Practice Address - Street 1:780 BAY BLVD
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5259
Practice Address - Country:US
Practice Address - Phone:619-842-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004145363LP0808X
IL041.407813163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse